Hepatomegaly and Focal Liver Lesions Flashcards
is a solid liver lesion more likely to be malignant in a younger or older patient?
older
what is more common in the absence of liver disease, primary liver cancer or metastases to the liver?
metastases to the liver
what is the most common solid liver tumour in non-cirrhotic patients?
haemangioma
name four benign liver lesions
haemangioma
focal nodular hyperplasia
adenoma
liver cysts
name two primary liver cancers
hepatocellular carcinoma
cholangiocarcinoma
what is the most common liver tumour?
haemangioma
is haemangioma more common in males or females?
females
describe the appearance of haemangioma
usually one, small tumour
what symptoms are usually present with haemangioma?
none
what investigations are done into haemangioma?
ultrasound
CT
MRI
what is seen on an ultrasound of a haemangioma?
a well demarcated echogenic spot
what is seen on a CT of a haemangioma?
venous enhancement from the periphery to the centre
what treatment is done for haemangioma?
none
what happens in focal nodular hyperplasia (FNH)?
a benign nodule of normal liver tissue forms
what causes focal nodular hyperplasia?
a congenital vascular anomaly
name two conditions associated with focal nodular hyperplasia
osler-webb-rendu
haemangioma
what does FNH look like when imaged?
a central scar containing a large artery, with radiating branches to the periphery
what age group and gender most commonly gets FNH?
young/middle aged women
what symptoms are associated with FNH?
none or minimal pain
what is FNH?
focal nodular hyperplasia
what four investigations are done for suspected FNH?
ultrasound
CT
MRI
FNA
what is FNA?
fine needle aspiration
what is seen on ultrasound in FNH?
a nodule with varying echogenicity
what is seen on CT in FNH?
a hypervascular mass with a central scar
what is seen on FNA in FNH?
normal hepatocytes and kupffer cells with a central core
what treatment is done for FNH?
none is necessary
what is a hepatic adenoma?
a benign neoplasm composed of normal hepatocytes
is hepatic adenoma more common in males or females?
females
what two chemicals are associated with hepatic adenoma?
contraceptive hormones
anabolic steroids
what symptoms are associated with hepatic adenoma?
none
may have RUQ pain
what rare ways may hepatic adenoma present?
rupture
haemorrhage
malignant transformation
is malignant transformation of hepatic adenoma more common in males or females?
males
what lobe is most commonly affected by hepatic adenoma?
the right lobe
what is adenomatosis?
multiple adenomas in the liver
what is adenomatosis associated with?
glycogen storage diseases
what four investigations may be done into hepatic adenoma?
ultrasound
CT
MRI
FNA
what conservative treatment can be done for hepatic adenoma?
stop hormones
lose weight
what should be done for adenomas present in males?
surgical excision, irrespective of size
what is done for hepatic adenomas in females?
imaging after six months
what is done for a hepatic adenoma under 5cm or reducing in size in females?
an annual MRI